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Ex vivo lung perfusion as a human platform for preclinical small molecule testing
Nathaniel M. Weathington, … , Bill B. Chen, Mauricio Rojas
Nathaniel M. Weathington, … , Bill B. Chen, Mauricio Rojas
Published October 4, 2018
Citation Information: JCI Insight. 2018;3(19):e95515. https://doi.org/10.1172/jci.insight.95515.
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Resource and Technical Advance Inflammation Pulmonology

Ex vivo lung perfusion as a human platform for preclinical small molecule testing

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Abstract

The acute respiratory distress syndrome (ARDS) causes an estimated 70,000 US deaths annually. Multiple pharmacologic interventions for ARDS have been tested and failed. An unmet need is a suitable laboratory human model to predictively assess emerging therapeutics on organ function in ARDS. We previously demonstrated that the small molecule BC1215 blocks actions of a proinflammatory E3 ligase–associated protein, FBXO3, to suppress NF-κB signaling in animal models of lung injury. Ex vivo lung perfusion (EVLP) is a clinical technique that maintains lung function for possible transplant after organ donation. We used human lungs unacceptable for transplant to model endotoxemic injury with EVLP for 6 hours. LPS infusion induced inflammatory injury with impaired oxygenation of pulmonary venous circulation. BC1215 treatment after LPS rescued oxygenation and decreased inflammatory cytokines in bronchoalveolar lavage. RNA sequencing transcriptomics from biopsies taken during EVLP revealed robust inflammatory gene induction by LPS with a strong signal for NF-κB–associated transcripts. BC1215 treatment reduced the LPS induction of genes associated with inflammatory and host defense gene responses by Gene Ontology (GOterm) and pathways analysis. BC1215 also significantly antagonized LPS-mediated NF-κB activity. EVLP may provide a unique human platform for preclinical study of chemical entities such as FBXO3 inhibitors on tissue physiology.

Authors

Nathaniel M. Weathington, Diana Álvarez, John Sembrat, Josiah Radder, Nayra Cárdenes, Kentaro Noda, Qiaoke Gong, Hesper Wong, Jay Kolls, Jonathan D’Cunha, Rama K. Mallampalli, Bill B. Chen, Mauricio Rojas

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Figure 1

LPS induces gas exchange impairment in EVLP that is abrogated by BC1215.

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LPS induces gas exchange impairment in EVLP that is abrogated by BC1215....
(A) The EVLP setup enables delivery of LPS into the pulmonary artery feed with measurement of gas exchange via the pulmonary arterial and venous ports, measurement of ventilator and vascular pressures, and bronchoscopic drug delivery and sampling. (B) Experimental protocols for LPS exposure (5 μg/Kg ideal body weight of donor), BC1215 treatment (2.5 mg by bronchoscope), physiology evaluation, and sample collection. (C and D) PAP and resistance were not significantly different between groups over 6 hours of EVLP. (E) Static compliance on EVLP is low across all preparation evaluated. (F) Wet/dry weight ratios of lungs did not differ over time or between groups. (G) Pulmonary vein perfusate oxygen content decreases over time after LPS exposure but remains stable when BC1215 is administered. (H) Change in perfusate oxygenation from 1 hour to 6 hours after ventilation start is significantly decreased by LPS, with normalization by BC1215 treatment (mean ± SEM; *P < 0.05, **P < 0.01 by 2-way ANOVA; n = 3). (I) Albumin concentration in perfusate is maintained throughout EVLP. (J) Changes in BAL albumin content increases in the LPS group but not in BC1215-treated preparations. (K) Representative histology micrographs from all conditions.

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